Socioeconomic Impact on Outcomes During the First Year of Life of Patients with Single Ventricle Heart Disease: An Analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry.

Autor: de Loizaga SR; Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 2003, Cincinnati, OH, 45229, USA. sarah.deloizagacarney@cchmc.org., Schneider K; Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 2003, Cincinnati, OH, 45229, USA., Beck AF; Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 2003, Cincinnati, OH, 45229, USA.; University of Cincinnati, Cincinnati, OH, USA., Zang H; Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 2003, Cincinnati, OH, 45229, USA., Ollberding N; Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 2003, Cincinnati, OH, 45229, USA.; University of Cincinnati, Cincinnati, OH, USA., Tweddell JS; Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 2003, Cincinnati, OH, 45229, USA.; University of Cincinnati, Cincinnati, OH, USA., Anderson JB; Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 2003, Cincinnati, OH, 45229, USA.; University of Cincinnati, Cincinnati, OH, USA.
Jazyk: angličtina
Zdroj: Pediatric cardiology [Pediatr Cardiol] 2022 Mar; Vol. 43 (3), pp. 605-615. Date of Electronic Publication: 2021 Oct 30.
DOI: 10.1007/s00246-021-02763-2
Abstrakt: Socioeconomic status (SES) affects a range of health outcomes but has not been extensively explored in the single ventricle population. We investigate the impact of community-level deprivation on morbidity and mortality for infants with single ventricle heart disease in the first year of life. Retrospective cohort analysis of infants enrolled in the National Pediatric Cardiology Improvement Collaborative who underwent staged single ventricle palliation examining mortality and length of stay (LOS) using a community-level deprivation index (DI). 974 patients met inclusion criteria. Overall mortality was 20.5%, with 15.7% of deaths occurring between the first and second palliations. After adjusting for clinical risk factors, the DI was associated with death (log relative hazard [Formula: see text] = 8.92, p = 0.030) and death or transplant (log relative hazard [Formula: see text] = 8.62, p = 0.035) in a non-linear fashion, impacting those near the mean DI. Deprivation was associated with LOS following the first surgical palliation (S1P) (p = 0.031) and overall hospitalization during the first year of life (p = 0.018). For every 0.1 increase in the DI, LOS following S1P increased by 3.35 days (95% confidence interval 0.31-6.38) and total hospitalized days by 5.08 days (95% CI 0.88-9.27). Community deprivation is associated with mortality and LOS for patients with single ventricle congenital heart disease. While patients near the mean DI had a higher hazard of one year mortality compared to those at the extremes of the DI, LOS and DI were linearly associated, demonstrating the complex nature of SES factors.
(© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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